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Multidisciplinary Team Management of Hepatocellular Carcinoma in the MENA Region: Current Practices, Challenges, and
Mohamed El-Kassas1,2, Rofida Khalifa3, Khalid M AlNaamani2,4
1Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt.
Insights
Multidisciplinary teams (MDTs) are crucial for managing hepatocellular carcinoma (HCC) in the Middle East and North Africa (MENA). Challenges like limited resources and technology hinder optimal HCC care, necessitating improvements in MDT support and digital health integration.
Area of Science:
- Hepatobiliary Medicine
- Oncology
- Health Services Research
Background:
- Hepatocellular carcinoma (HCC) presents a significant mortality challenge, particularly in the Middle East and North Africa (MENA) region.
- Multidisciplinary teams (MDTs) are recognized as vital for optimizing the management of complex diseases like HCC.
- Variations in MDT implementation and effectiveness across different healthcare systems necessitate regional evaluation.
Purpose of the Study:
- To assess the structural components of MDTs managing HCC in the MENA region.
- To evaluate the decision-making processes employed by these MDTs.
- To identify the key challenges encountered by MDTs in HCC treatment centers across the MENA region.
Main Methods:
- A cross-sectional, multicenter study design was employed.
- Data were collected via electronic questionnaires distributed to representatives from 53 HCC treatment centers in 11 MENA countries.
- The survey assessed MDT composition, meeting frequency, decision-making, guideline adherence, patient pathways, and challenges.
Main Results:
- Eighty-four point nine percent of surveyed centers (n=45) reported established MDTs, with hepatology, interventional radiology, medical oncology, and hepatobiliary surgery as core specialties.
- Barcelona Clinic Liver Cancer staging was utilized by 95.6% of centers.
- Key challenges included resource limitations (13.2%), financial constraints (13.2%), patient nonadherence (9.4%), and limited access to advanced technology (11.3%). Telemedicine and clinical trial participation remain underutilized.
Conclusions:
- MDTs play a critical role in HCC management within the MENA region, with general adherence to evidence-based guidelines.
- Significant gaps exist in resource availability, technological integration, and patient-centered decision-making processes.
- Enhancing MDTs through improved resource allocation, digital health adoption, and increased clinical trial engagement is crucial for improving HCC patient outcomes in the region.
Purpose:
Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality, with a high disease burden in the Middle East and North Africa (MENA) region. Multidisciplinary teams (MDTs) are essential for optimizing HCC management; however, their implementation and impact may vary across healthcare settings. This study evaluates the structure, decision-making processes, and challenges faced by MDTs in HCC treatment centers across the MENA region.
Patients And Methods:
This cross-sectional, multicenter study surveyed representatives from 53 HCC treatment centers across 38 cities in 11 MENA countries. A structured questionnaire was electronically distributed to assess MDT composition, meeting frequency, decision-making processes, adherence to clinical guidelines, patient management pathways, and challenges in HCC treatment.
Results:
Among the surveyed centers, 84.9% (n=45) reported having an established MDT. The most common specialties involved in MDT composition were hepatology (100%), interventional radiology (97.8%), medical oncology (91.1%), and hepatobiliary surgery (80%). Barcelona Clinic Liver Cancer staging was used in 95.6% of centers. Despite acknowledging MDT benefits, major challenges were documented by participants, including resource limitations (13.2%), financial constraints (13.2%), patient nonadherence (9.4%), and limited access to advanced technology (11.3%). Telemedicine was underutilized (9.4% of centers), and only 15.1% experienced participation in clinical trials.
Conclusion:
Our result highlights the pivotal role of MDTs in HCC management in the MENA region, demonstrating adherence to evidence-based guidelines and exposing critical gaps in resource availability, technology integration, and patient-centered decision-making. Strengthening MDTs through enhanced resource allocation, digital health adoption, and increased clinical trial participation is essential to improving HCC outcomes in the region.
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